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Mental Ills Linked to Marijuana

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Two psychiatrists have found that “normal” youngsters can suffer serious psychological disturbances following regular smoking of marijuana, without the use of other drugs.

They said their findings had suggested that adolescents might be particularly vulnera ble to the effects of this mind altering drug.

The doctors, Harold Kolan sky and William T. Moore of Philadelphia, described 38 such youngsters, aged 13 to 24, in report published today in the Journal of the American Medi cal Association.

None of the young patients— believed to be the largest such group described to date—had used any drugs other than mari juana or had had any signs of mental illness prior to smoking marijuana, the doctors re ported.

Eight of the youngsters be came psychotic while on mari juana, and four attempted sui cide. The 30 others showed less severe disturbances, ranging from paranoid delusions of grandeur to excessive sexual promiscuity.

“We're talking about grad ual, cumulative effects, not psychotic episodes,” Dr. Moore said in an interview. Since such patients are rarely seen in the hospital emergency ward or the psychiatrist's office, he said, this would account in part for the relatively infrequent re ports to date of psychological disturbance precipitated by marijuana.

The new report challenges the widely held view and previ ous research finding that mari juana is a relatively mild intox icant causing serious psycho logical disturbances only in rare cases when a person takes a dose far stronger than he is accustomed to.

Drs. Kolansky and Moore said reports that “large numbers of adolescents and young adults smoke marijuana regularly with out developing symptoms” are “unsupported by scientific evi dence” since youngsters have not been evaluated psychi atrically.

Nonetheless, the conclusions of the doctors are already being questioned by other marijuana experts who were informed of the results. “They just don't jibe with the experience and find ings of other researchers,” one such expert remarked. But he and others reserved more de finitive comment until they could carefully examine the Philadelphia report.

Among the typical cases de scribed in the Journal report are the following:

¶A 16‐year‐old girl who smoked marijuana three or four times a week for two years lost interest in her academic work, became hostile and impulsive and dropped out of school. She developed paranoid ideas about her brother‐in‐law's sexual in terest in her, became severely depressed and tried to hang herself. After she stopped smoking marijuana, her depres sion and paranoia gradually disappeared.

¶A 19‐year‐old boy who en tered college with an A average started smoking marijuana dur ing his freshman year, became apathetic, disoriented and de pressed and failed all his courses. Early in the year he had gone to a college counselor because he thought he was hav ing a “thinking problem” due to marijuana, but was told that the drug was harmless.

¶Thirteen unmarried girls, aged 13 to 22, became sexually promiscuous after using mari juana. Seven became pregnant and four developed venereal disease. All showed symptoms of confusion, apathy, depres sion, feelings of isolation, list lessness and suicidal ideas. Most smoked marijuana three or more times a week.

Some Had Delusions

A number of other patients had delusions such as the idea that they were the Messiah or the Eastern potentate of the Ku Klux Klan.

All 38 patients in the report were regular users of mari juana — smoking it at least twice a week, usually two or more cigarettes at a time. Drs. Kolansky and Moore, who are both on the staff of the Phila delphia Association for Psycho analysis, noted that the sever ity of psychological difficulties seemed directly related to how much the youngster smoked.

They also found that the symptoms tended to disappear within months and sometimes weeks after the smoking had been stopped. However, they added, several young patients who have been off marijuana for as long as two years still show signs of disturbed brain function, including impaired memory, difficulty in putting thoughts into words and in ability to concentrate while reading.

The patients in today's re port were gleaned from about 250 marijuana users seen by the psychiatrists since around 1965. Deliberately excluded from the report were all those known to have used drugs other than marijuana and those with prior, psychological dif ficulties.

The doctors said in telephone interviews that they had ob‐ served similar psychological disturbances in adults who had smoked marijuana, but that in adolescents and young adults the effects had been more ex aggerated. The effects were most severe, they said, in per sons with psychological prob lems to begin with.

A common thread through all the cases was a disturbance in the functions of the ego, that part of the personality responsible for controlling im pulses, distinguishing fact from fantasy, judgment, self‐image and development of personal relationships.

Since normal adolescence is a struggle for mastery of these ego functions, Dr. Moore sug gested that marijuana thwarts the adolescent's effort to “grow up” and may lead to “a lot of young adults who are psy chologically still children.”

“The adolescent is especially vulnerable,” Dr. Kolansky added, “because his personality is naturally unstable and chang ing. The adolescent who smokes marijuana is in effect playing chemical Russian roulette. And if the youngster has psychologi cal problems to begin with, marijuana can be dynamite—it can hit like a bomb.”

Others Note Similar Effects

Other psychiatrists have noted effects similar to those de scribed by the Philadelphia doc tors. Four weeks ago in the same journal, Dr. Arthur Korn haber, child psychiatrist from Katonah, N.Y., described the effect of marijuana smoking in 50 teen‐agers, many of whom also used other drugs.

Marijuana, he concluded, “locks the developing youth Into a state that nature would relinquish.”

“He psychologically remains an adolescent,” and a seriously disturbed adolescent,” he said.

Dr. Kornhaber suggested that marijuana caused a kind of “chemical frontal lobotomy,” characterized by immediate eu phoria and followed by a pro longed depressant effect, con fusion and memory disorienta tion. He has concluded that marijuana may be “toxic to the human nervous system during growth and development.”

Harvard Man Critical

On the other hind, Dr. Lester Grinspoon, a psychiatrist at Harvard University, said that, “based on my own experience and the experience of many others with marijuana smokers, I am very skeptical” about these reports. “You can't tell which is cause and which is effect—the drug, the life style or the psy chological problem.”

Dr. Grinspoon who is the author of a new, carefully re searched book, “Marijuana Re considered,” said that in any case he “certainly would not want, adolescents using this or any other drug.” He noted that many substances and life events could precipitate “functional psychosis” people with “shaky egos” and that “adoles cence is a state when under normal circumstances the ego is shaky.”

He cautioned, however, against “alarming reports” of marijuana's supposed bad ef fects that are based on “slim data” because he said they would further widen the credi bility gap between the young and the medical profession.

A version of this archives appears in print on April 19, 1971, on Page 24 of the New York edition with the headline: Mental Ills Linked to Marijuana. Order Reprints|Today's Paper|Subscribe